Rep. Rick Larsen (WA-02) and Washington state Insurance Commissioner Mike Kreidler today discussed the impacts of Trumpcare, the Republican plan to repeal and replace the Affordable Care Act, on Washington state during a hearing organized by House Democrats.

Insurance Commissioner Kreidler opened by speaking to the benefits of the Affordable Care Act. "The state of Washington fully implemented the Affordable Care Act...we saw a decline in the number of people who were uninsured from 14 to 5.8 percent. The individual market is thriving in the state of Washington - we have more carriers in the individual market today than we did before the Affordable Care Act...150 plans and 13 insurers in the market. We are doing extremely well in the state of Washington."

According to Kreidler, Washington state's analysis found that "the impact of Trumpcare on the state of Washington would be devastating... The [rate of uninsured] would go from 5.8 to 15 percent - higher than it was before the Affordable Care Act... lower and middle income people in rural areas are hit the hardest. People under the age of 30 and those between 50-64 are hard hit. People earning about $30,000 are by far the ones that are most seriously impacted. 81% of the people the Medicaid expansion program are at the federal poverty level or lower - they are not going to go out and buy an individual policy, they can't afford it. It means that they go uninsured and I am extremely worried about that."

Larsen asked about the impacts of eliminating the individual mandate: "can you compare the ability of the individual mandate to keep or bring people in the pool versus the 30 percent tax that the Republican's propose for folks who do not keep continuous coverage and the likelihood of success of a 30 percent tax versus the alternative?"

In response, Kreidler pointed out that Trumpcare's penalty does not motivate individuals - especially younger, healthier individuals - to enter into the insurance pool. Trumpcare's 30 percent penalty will only incentivize younger and healthier individuals to "sit it out and be prepared to pay the penalty once they become sick...you could see deterioration in the individual market as a result."

"It follows that based on that analysis there would be more price pressure on seniors who, under the Republican plan, are already getting hit pretty hard," said Larsen. Kriedler agreed: "Absolutely, you deteriorate the quality of the risk pool. You wind up with more sick people, less healthy people and insurance works pretty bad when you only have sick people in the market."

Key provisions of Trumpcare include repealing the individual mandate, doing away with Affordable Care Act tax credits that low- and middle-income families rely on to afford health insurance, phasing out critical federal healthcare resources for states and repealing the taxes on wealthy Americans which currently finance the Affordable Care Act. The legislation also reduces the quality of healthcare by removing health insurance benefit requirements for some lower-income Americans, which could exacerbate the opioids crisis by leaving up to 1.3 million people without access to substance abuse services.

According to a report on Trumpcare from the Congressional Budget Office, 24 million fewer Americans would have health insurance over the next decade, average healthcare premiums would rise by 15-20% over the next two years and critical federal healthcare funding to states would be cut by $880 billion. Previous reports from the Joint Committee on Taxation show that Trumpcare will also provide a $600 billion tax break - primarily for the wealthiest Americans.